Staff cuts at the Social Security Administration won't be as widespread or as quick as seemed likely a few weeks ago, when the Office of Management and Budget proposed cutting the agency's 79,174 fulltime employe slots by 19,000 over the next three years. The assumption was that the program to modernize the agency's computer systems would allow SSA to eliminate that many employes. Now, sources say, the plan has been softened somewhat: the cut will probably be only 17,000 and will be stretched over five or six years. MORE EXPERIMENTS? . . .
Although Congress in 1980 authorized the Health and Human Services Department to conduct experiments to determine whether handicapped persons could be moved off the Social Security disability rolls and into productive jobs, only one project has been started.
Despite the enthusiasm of Sens. Robert J. Dole (R-Kan.) and David F. Durenberger (R-Minn.), the only project that has gotten off the ground is one involving Abbott Laboratories. The firm has agreed to hire up to 20 persons who might be capable of working if the daily intravenous feeding they need could be done at home at night instead of in a hospital.
Although Rep. J.J. (Jake) Pickle (D-Tex.), chairman of the House Ways and Means subcommittee on Social Security, has asked SSA to go ahead with more experiments of this type, as well as ones involving vocational rehabilitation and placement of disabled people, questions have been raised of whether the law that gives the agency the authority to use Social Security trust fund revenues for the experiments is about to expire.
OMB has told HHS that the experiments could be authorized under other laws, but that funds for the projects probably would have to be set aside in the regular appropriations bills. Aides say Pickle is growing impatient with the legalisms and wants the program to get off the ground. He may offer legislation to make sure it does. WORKFARE UPDATE . . .
A "workfare" program in West Virginia, in which beneficiaries of the federal-state Aid to Families with Dependent Children program work off their benefits at community jobs, has made a promising start, according to the Manpower Demonstration Research Corp., which is monitoring such projects in eight states.
Four months after the program started, 40 percent of the state's 5,000 fathers receiving welfare were participating, although the rate was only 10 percent for mothers receiving welfare who were single parents of children aged 6 or older. A survey of 94 participants and their supervisors in 1983-84 revealed that most welfare clients believed that their work made a valuable contribution and was not just make-work, that supervisors felt that the participants' job performance and dependability compared well to their regular employes', and that about 80 percent of the participants thought that the requirement that they work for their benefits was a "satisfactory" or "very satisfactory" arrangement. A TRILLION DOLLARS' WORTH OF HEALTH . . .
Robert Roberts, executive vice president of Allstate Life Insurance Co., told a health conference recently that his company projects that the nation's health-care outlays will grow from the present $355 billion a year to $1 trillion in 1993. Roberts added, "Our studies show that about 30 percent of all medical costs result from fraud, duplication, waste and abuse." WAIVER FOR NEW JERSEY . . .
HHS has granted New Jersey a new three-year waiver under which HHS has agreed to continue following the state's cost-control rules when it pays Medicare expenses, instead of the Medicare program rules that the rest of the country has to follow.
Under the New Jersey system, the state sets hospital payment rates for all public and private insurers. Gov. Thomas H. Kean said the basic requirement for the waiver was that Medicare outlays to New Jersey hospitals not exceed the amounts that Medicare would have to pay them if the state had followed the national Medicare rules. Kean said that as a result of the waiver, the Medicare program would save $126 million over three years. MORE SAVINGS? . . .
A recent report by HHS Inspector General Richard P. Kusserow says Medicare could save $720 million over several years if it stopped paying hospitals for capital depreciation on facilities built with federal funds under the Hill-Burton Act and other legislation. Medicare now pays hospitals that participate in the Medicare program funds to cover their capital depreciation, and by counting facilities that were built with federal funds, Kusserow said, "the government is paying twice for hundreds of millions of dollars in provider assets."
In another report, Kusserow said the $75 annual deductible that Medicare patients must pay on their doctors' bills should be immediately increased to $100 and then increased annually, based on the inflation rate. Kusserow said that this would reduce net federal outlays by $2.8 billion over five years. He said the original deductible, set at $50 a year in 1967, has been raised only twice. If it had been raised annually to keep pace with the Consumer Price Index, he said, it would now be $155. Kusserow said surveys of Blue Cross and private health-insurance policies show that most have deductibles of at least $100 a year, and many have deductibles of $150 or more.